Hematology: 101 Morphology Updates

DESCRIPTION

Hematology

Timely morphology resource based on ongoing series of morphology updates published in the American Journal of Hematology since 2008

This is the first book of its kind, written by renowned author Professor Barbara J. Bain, featuring a collection of instructive cases with interesting morphological features initially published in the American Journal of Hematology. This new book aims to bring these interesting and instructive cases to a wider readership. This book features updated cases and a “Test Yourself” section to aid in reader comprehension and information retention.

Cases covered in Hematology: 101 Morphology Updates include:

·         The significance of irregularly contracted cells and hemighosts in sickle cell disease, and striking dyserythropoiesis in sickle cell anemia following an aplastic crisis

·         Prominent Howell-Jolly bodies when megaloblastic anemia develops in a hyposplenic patient, and unusual aspects of G6PD deficiency

·         The cause of sudden anemia revealed by the blood film, chorea-acanthocytosis and dysplastic neutrophils in an HIV-positive woman

·         Neutrophil dysplasia induced by granulocyte colony-stimulating factor, and diagnosis of pyrimidine 5'-nucleotidase deficiency suspected from a blood film

Hematology: 101 Morphology Updates is a key resource for consultant hematologists and clinical scientists, trainee hematologists and biomedical scientists. The audience may use this book to solve difficult diagnostic problems or as a source of teaching cases: for both personal learning, including exam revision or solving difficult cases, and as a teaching resource.

TABLE OF CONTENTS

Preface x

Note to the reader xi

Acknowledgements xii

Abbreviations xv

1 Malaria – one swallow makes a summer 1

2 The significance of irregularly contracted cells and hemighosts in sickle cell disease 2

3 Striking dyserythropoiesis in sickle cell anemia following an aplastic crisis 3

4 A normal mean cell volume does not exclude a diagnosis of megaloblastic anemia 4

5 Prominent Howell–Jolly bodies when megaloblastic anemia develops in a hyposplenic patient 6

6 A ghostly presence – G6PD deficiency 7

7 G6PD deficiency in patients identified as female 8

8 The cause of sudden anemia revealed by the blood film 9

9 Choreo-acanthocytosis 10

10 Lead poisoning 12

11 Dysplastic neutrophils in an HIV-positive woman 14

12 Help with HELLP 15

13 Neutrophil dysplasia induced by granulocyte colony-stimulating factor 16

14 COVID-19 and acute kidney injury 17

15 Diagnosis of pyrimidine 5′nucleotidase deficiency suspected from a blood film 19

16 Bone marrow aspirate in Chédiak–Higashi syndrome 20

17 Phytosterolemia 21

18 Pseudo-Chédiak–Higashi inclusions together with Auer rods in acute myeloid leukemia 22

19 Botryoid nuclei resulting from cocaine abuse 23

20 Infantile pyknocytosis 25

21 Splenic rupture in cytomegalovirus infection 27

22 A new diagnosis of monoclonal B-cell lymphocytosis with cytoplasmic inclusions in a patient with COVID-19 29

23 Pseudoplatelets and apoptosis in Burkitt lymphoma 31

24 What is a promonocyte? 32

25 Persistent neonatal jaundice resulting from hereditary pyropoikilocytosis 34

26 Auer rods or McCrae rods? 36

27 Observation of Auer rods in crushed cells in acute promyelocytic leukemia 37

28 Alpha chain inclusions in peripheral blood erythroblasts and erythrocytes 39

29 Dyserythropoiesis in visceral leishmaniasis 41

30 Compound heterozygosity for hemoglobins S and D 42

31 Granular B lymphoblastic leukemia 43

32 Hyposplenism in adult T-cell leukemia/lymphoma 44

33 Voxelotor in sickle cell disease 45

34 The importance of a negative image 48

35 Seeing what isn’t there 49

36 A young woman with sudden onset of a severe coagulation abnormality 50

37 Immature Plasmodium falciparum gametocytes in bone marrow 51

38 Acute myeloid leukemia with myelodysplasia-related changes showing basophilic differentiation 52

39 Thiamine-responsive megaloblastic anemia in an Iraqi girl 53

40 Teardrop poikilocytes in metastatic carcinoma of the breast 54

41 A blood film that could have averted a splenectomy 55

42 Russell bodies and Mott cells 57

43 Dutcher bodies 59

44 Acute myeloid leukemia with inv(16)(p13.1q22) 61

45 Dysplastic macropolycytes in myelodysplasia-related acute myeloid leukemia 63

46 Diagnosis of cystinosis from a bone marrow aspirate 64

47 Emperipolesis in a patient receiving romiplostim 65

48 Mechanical hemolysis: a low mean cell volume does not always represent microcytosis 66

49 Transplant-associated thrombotic microangiopathy 67

50 Neuroblastoma in the bone marrow 69

51 Gray platelet syndrome 70

52 Diagnosis of systemic lupus erythematosus from a bone marrow aspirate 71

53 Diagnosis from a blood film following a dog bite 72

54 Interpreting a postpartum Kleihauer test 73

55 Dengue fever in returning travellers 74

56 Auer rod-like inclusions in multiple myeloma 76

57 Azurophilic granules in myeloma cells 77

58 Plasmodium knowlesi 78

59 The cytological features of NPM1-mutated acute myeloid leukemia 79

60 Irregularly contracted cells in Wilson disease 81

61 Pseudo-Pelger–Huët neutrophil morphology due to sodium valproate toxicity 82

62 The distinctive cytological features of T-cell prolymphocytic leukemia 83

63 Eosinophil morphology in the reactive eosinophilia of Hodgkin lymphoma 86

64 Malaria pigment 87

65 Salmonella colonies in a bone marrow film 88

66 Severe babesiosis due to Babesia divergens acquired in the UK 89

67 Congenital acute megakaryoblastic leukemia 91

68 Basophilic differentiation in transient abnormal myelopoiesis 92

69 Methylene blue-induced Heinz body hemolytic anemia in a premature neonate 93

70 Neutrophil vacuolation in acetominophen-induced acute liver failure 95

71 Howell–Jolly bodies in acute hemolytic anemia 96

72 The distinctive micromegakaryocytes of transformed chronic myeloid leukemia 97

73 Copper deficiency 98

74 Chronic neutrophilic leukemia 99

75 Neutrophilic leukemoid reaction in multiple myeloma 101

76 Persistent polyclonal B lymphocytosis 103

77 Non-hemopoietic cells in the blood and bone marrow 104

78 It’s a black day – metastatic melanoma in the bone marrow 105

79 Dehydrated hereditary stomatocytosis 106

80 Circulating lymphoma cells in intravascular large B-cell lymphoma 107

81 Unusual inclusions in hemoglobin H disease post-splenectomy 108

82 An unexpectedly bizarre blood film in hemoglobin H disease 109

83 Acute myeloid leukemia with a severe coagulopathy and t(8;16)(p11;p13) 111

84 Cold autoimmune hemolytic anemia secondary to atypical pneumonia 113

85 A confusing ‘white cell count’ – circulating micromegakaryocytes in post-thrombocythemia myelofibrosis 114

86 Diagnosis of follicular lymphoma from the peripheral blood 115

87 Transformation of follicular lymphoma 117

88 Cytology of systemic mastocytosis 118

89 Systemic mastocytosis – the importance of looking within bone marrow fragments 119

90 Schistocytosis is not always microangiopathic hemolytic anemia 120

91 Hemoglobin C disease 121

92 Hemoglobin St Mary’s 122

93 Congenital sideroblastic anemia in a female 123

94 A puzzling case of methemoglobinemia 125

95 Hodgkin lymphoma in a bone marrow aspirate 127

96 Giant proerythroblasts in pure red cell aplasia due to parvovirus B19 infection in a patient with rheumatoid arthritis 128

97 A myeloid neoplasm with FIP1L1::PDGFRA presenting as acute myeloid leukemia 129

98 Breast implant-associated anaplastic large cell lymphoma 131

99 Large granular lymphocytosis induced by dasatinib 132

100 The distinctive cytology and disease evolution of blastic plasmacytoid dendritic cell neoplasm 134

101 Platelet phagocytosis as a cause of pseudothrombocytopenia 136

Test yourself 137

Answers to test cases 145

Index 152